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Home My WebLink AboutBDE-22-002500 Commonwealth of Official Use Only fi.: , Massachusetts Permit No. BLDE-22-002500 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:11/2/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 44 LILY POND DR Owner or Tenant PUCCINI JOAN (LIFE EST) Telephone No. Owner's Address SVARCZKOPF RICHARD W(LIFE EST),44 LILY POND DR, SOUTH YARMOUTH, w' , "`-'' �'*.� °� Is this permit in conjunction with a building permit? Yes 0 No 0 Checkc l ' l ( giro� ate.j;o ) Purpose of Building Utility Authorization No. '' - Service " /"'e '� ExistingAmps Volts Overhead 0 Undgrd ❑ No. MetOs .i' ",,, New Service Amps Volts Overhead 0 Undgrd 0 No.of M to•s� ,, ' r .N. Number of Feeders and Ampacity fi F E, ,-< Ns Location and Nature of Proposed Electrical Work: Remodel bathroom , -.-, e*N Completion of the following table may be wkiul the`f' ,peclo of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool g bove ❑ grnd. ❑ No.of Emergency Lighting rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 P 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 :) I certify,under the pains and penalties operjury,that the information on this application istrue and complete. FIRM NAME: Glenn W Crafts Licensee: Glenn W Crafts Signature Tel. NO.: 10020 (If applicable,enter"exempt"in the license number line.) Address:259 GREAT WESTERN RD, SOUTH DENNIS MA 026603792 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 111-2. i2.1 ,_ -... Official Use Only • Commonwealth of Ma.ssachusett.s Permit No, Department of Fires Services .• -_--_-.F a,-..--,-z-:1 Occupancy and Fee Cl'ecked -ifillifF!' BOARD OF FIRE PREVENTION REGULATIONS Rev.911?IgalsilLal" K.) - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cede(1vIEC),527 C74R 12.00 (PLEASE.PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 I — ( — -City or Town of: k-/CLV—VIAn So To the Inspector of Wires: By this application the underai nod gives notice of his or her intention to perform the electrical work described below: Location(Street& ber) t‘1 •? y-,i 1 Owner or Tenant *C-.-\.&OkkR3.._ CA-Nr . Telephone No.77(1-a(Z"/Ott/ • Owner's Address \f Ll v-% ./•,2 .g..) , CVIVC) IA0 . 1 \ Is tins permit in'conjunction with a.huildin permit? Yes Er No ED (Check Appropriate Box) Purpose of Building i C.' Utility.Authorization No. • s lihristing Services_CLL)C_' Amps i 1'57? Volts- Overhead fR .-- Undgrd El No.of Meters _i____ ... liffiv_Servigg Amps i Volts Overhead 0 Undgrd El No.of Meters ____ Number of Feeders and Ampadty ' Location and Nature of Proposed Electrical Work: 'F. ( ( , - MQAL,0 ---4-- • Completion of theYailowing sable ma be waived by the inspector of Wires. ----------"---R:---—."7---- IN a.3f Total No.of Recessed Luminaires .re'Ceal.-Susp.(Paddle)Fans Ilansformes KVA No.of Luminaire Outlets —1-ic.of Ilot Tab's Generalp-, KVA No.oi.Luniinafre , i Ajam ----,---1,11, .ito.e._,___ ryEmunierieney Lighting '''"•"'g °° grnd. grnd. No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches . No.of GaTBurn No.ofDeteetion and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers eat Totals P Degictlo ileTtlIng. Devices : No.of Dishwashers Spacearea Heating KW . • Local El ivlualciRal E3 Other No.of Dryers Heating APPliances . ICW SecNilo.ritYofSestems7cesti*altql1 uivalent • No.of Wg_Per fcw No.of No.of Data Wiring: rieaters - Si Ballasts No.of Devices or E alent No.Hydromassage Bathtubs No.of Motors !Total BY Telgo°.omPlt:Itetcaeti.suonr841141aTent OTHER: Attached additional detail If desired,or as require:,by the inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) • Work to Start Inspecticr:;t,.3 he requested in accordance with/vIEC Rule 10,and upon completion. INSURANCE CO Unless wttivea by the owner,uo permit for the performance of electrical work may issue unless • • the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The . undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND El OTHER cj (Specify) I certify, under the ains and enalties ofpetituy,that the information o Ls application is tru and complete • FIRM NAME: ,C... LIC.NO.: Licensee: _C2.1 CAI__ _ Signature •(If applicable,enter"exempt"in the Ii se number oe V us.Tel.No.: Address: i 6 AIL Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: -------- OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the"liability insurance coverage flOnnally required by law.By my signature below,ltereby waive this requirement:I am the(check one) 0 owner Downer's agent Owner/Agent Signathn • Telephone No, • ' PERMIT FEE:$ ' • .